@layout("/backend/common/_container.html"){
<div class="dhcc-form">
    <form method='post' id="cdcExpenseInfoForm" name="cdcExpenseInfoForm" enctype="multipart/form-data">
	
        <#Hidden id="id" value="${cdcExpense.id}"/>

		<#Input id="episodeId" name="就诊记录" value="${cdcExpense.episodeId}"/>
		<#Input id="costs" name="总费" value="${cdcExpense.costs}"/>
		<#Input id="pays" name="自付费" value="${cdcExpense.pays}"/>
		<#Input id="busExpenseTypeId" name="费用类型" value="${cdcExpense.busExpenseTypeId}"/>
		<#Input id="dataId" name="业务数据类型" value="${cdcExpense.dataId}"/>
		<#Input id="isActive" name="是否有效" value="${cdcExpense.isActive}"/>
        <div class="toolbar">
        	<#Button name="保存" id="ensure" icon="icon-w-save" clickFun="CdcExpenseInfoDlg.editSubmit()"/>
        	<#Button btnCss="l-bt-red" name="关闭" id="cancel" icon="icon-w-close" clickFun="CdcExpenseInfoDlg.close()"/>
        </div>
    </form>
</div>
<script src="${ctxPath}/static/backend/cdc/cdcexpense/cdcexpense_info.js"></script>
@}
